Treatise on Poisons by Sir Robert Christison
1. _Distension of the Stomach._—Mere distension of the stomach from
458 words | Chapter 48
excessive gluttony may cause sudden death. Generally indeed the symptoms
and appearances in the dead body show that death is the consequence of
apoplexy; but sometimes not. In order to preserve the continuity of the
succeeding remarks on the diseases of the stomach which imitate
poisoning, it may be useful to consider in the present place all the
varieties of the effects of distension.
Excessive distension of the stomach, then, sometimes causes sudden death
by inducing apoplexy, which is commonly of the congestive kind,—that is,
without rupture of vessels. Mérat has related an instructive case of
this kind. A man in good health, while greedily devouring an excellent
dinner, became suddenly blue and bloated in the face; a clammy sweat
broke out over his body; and he died almost immediately. On dissection
the stomach was found enormously distended with food, and the vessels of
the brain were so gorged, that the brain appeared too large to be
contained within the skull.[141]
There is reason, however, to suppose that death from distension is the
consequence not always of apoplexy,—but sometimes of an impression on
the stomach itself. Sir Everard Home relates the case of a child, who,
being left by its nurse beside an apple-pie, was found dead a few
minutes afterwards, and in whose body no appearance of note could be
discovered, except enormous distension of the stomach with the pie.—A
still more distinct case in point forms the subject of a medico-legal
report by Wildberg. A corpulent gentleman died suddenly fifteen minutes
after dinner; and as he lived on bad terms with his wife, a suspicion
arose that he had been poisoned. His wife said that he fell asleep
immediately after dinner; but had not slept many seconds, when he
suddenly awoke in great anguish, called out for fresh air, exclaimed he
was dying, and actually expired before his physician, who was instantly
sent for, could arrive. Wildberg found the stomach so enormously
distended with ham, pickles, and cabbage-soup, that, when the belly was
laid open, nothing could be seen at first but the stomach and colon.
Some white powder, found on the villous coat of the stomach, was at
first suspected to be arsenic; but it proved on analysis to be merely
magnesia, which the gentleman had been in the habit of taking
frequently. The diaphragm was pushed high into the chest by the
distended stomach. There was not any particular congestion in the brain.
Wildberg very properly ascribed death to simple over-distension of the
stomach.[142]—In all such cases the symptoms may be suspicious; but when
carefully considered they can scarce be said to resemble closely the
effects of irritant poisoning; and at all events the appearances in the
dead body will at once distinguish them.
Chapters
1. Chapter 1
2. PART II.—OF INDIVIDUAL POISONS.
3. CHAPTER I.
4. 1. _On the Action of Poisons through Sympathy._ In the infancy of
5. 2. _Of the Action of Poisons through Absorption._—If doubts may be
6. 1. _Quantity_ affects their action materially. Not only do they produce
7. 2. _As to state of aggregation_,—poisons act the more energetically the
8. 3. The next modifying cause is _chemical combination_. This is sometimes
9. 4. The effect of _mixture_ depends partly on the poisons being diluted.
10. 5. _Difference of tissue_ is an interesting modifying power in a
11. 6. With respect to differences arising from _difference of organ_, these
12. 7. _Habit and Idiosyncrasy._—The remarks to be made under the present
13. 8. The last modifying cause to be mentioned comprehends certain
14. CHAPTER II.
15. 1. The first characteristic is the _suddenness of their appearance and
16. 2. The next general characteristic of the symptoms of poisoning is
17. 3. Another characteristic is _uniformity in the nature of the symptoms_
18. 4. The fourth characteristic is, that _the symptoms begin soon after a
19. 5. Lastly, _the symptoms appear during a state of perfect health_. This
20. 1. As to the _suddenness of their invasion and rapidity of their
21. 2. As to the uniformity or _uninterrupted increase of the symptoms_, it
22. 3. It was stated above, that the third character, _uniformity in kind_
23. 4. In the next place, it was observed that some reliance may be placed
24. 5. Little need be said with regard to _the symptoms beginning, while the
25. 1. It may have been discharged by vomiting and purging. Thus on the
26. 2. The poison may have disappeared, because it has been all absorbed. It
27. 3. Poisons may not be found, because the excess has been decomposed.
28. 4. Lastly, the poison which has been absorbed into the system, and may
29. 1. The evidence derived from _the effects of suspected food, drink, or
30. 2. In the case of _the vomited matter_ or _contents of the stomach_
31. 3. The effects of _the flesh of poisoned animals_, eaten by other
32. 3. The next article, which relates to the proof of the administration of
33. 4. The next article in the moral evidence relates to the intent of the
34. 5. The next article among the moral circumstances,—the simultaneous
35. 6. The next article of the moral evidence relates to suspicious conduct
36. CHAPTER III.
37. CHAPTER I.
38. 1. _Arsenical_ White arsenic 185
39. 2. _Acids_ Sulphuric acid 32
40. 3. _Mercurials_ Corrosive sublimate 12
41. 4. _Other mineral irritants_ Tartar-emetic 2
42. 5. _Veget. irritants_ Colchicum 3
43. 7. _Opium_ Opium or Laudan. 180
44. 8. _Hydrocyanic acid_ Med. Hydroc. acid 27
45. 9. _Other veget. Narcotics_ Nux-vomica 3
46. 11. Unascertained 22
47. CHAPTER II.
48. 1. _Distension of the Stomach._—Mere distension of the stomach from
49. 2. _Rupture of the Stomach_ is not a common occurrence; but it sometimes
50. 3. _Rupture of the Duodenum_ is a very rare accident from internal
51. 4. Under the next head may be classed rupture of the other organs of the
52. 5. The next accident which may be noticed on account of its being liable
53. 6. _Of Bilious Vomiting and Simple Cholera._—Of all the diseases which
54. 7. _Of Malignant Cholera._—The history of this disease affords a fair
55. 8. _Of Inflammation of the Stomach._—Chronic inflammation of the stomach
56. 9. _Inflammation of the Intestines_ in its acute form is more common
57. 10. _Inflammation of the Peritonæum_, or lining membrane of the belly,
58. 11. The subject of _Spontaneous Perforation of the Stomach_ is an
59. 12. The _gullet_ may be perforated in a similar manner either with or
60. 13. _Perforation of the alimentary canal by worms_ may here also be
61. 14. The next diseases to be mentioned are melæna and hæmatemesis, or
62. 15. The last are _colic_, _iliac passion_, and _obstructed intestine_.
63. CHAPTER III.
64. 1. _When concentrated_ it is oily-looking, colourless, or brownish from
65. 2. _When diluted_, it may be distinguished from all ordinary acids by
66. 3. It is seldom that the medical jurist is called on to search for
67. 1. The most ordinary symptoms are those of the first variety,—namely,
68. 2. The second variety of symptoms belong to a peculiar modification of
69. 3. The third variety includes cases of imperfect recovery. These are
70. 4. The last variety comprehends cases of perfect recovery, which are
71. 1. _When concentrated_, nitric acid is easily known by the odour of its
72. 2. _In a diluted state_ this acid is not so easily recognised as the
73. 3. _When in a state of compound mixture_, nitric acid, like sulphuric
74. 1. Hydrochloric acid, _in its concentrated state_, is colourless, if
75. 2. _When diluted_, it is recognised with facility, first by
76. 3. In the last edition of this work I proposed for the detection of
77. CHAPTER IV.
78. CHAPTER V.
79. CHAPTER VI.
80. 1. In the form of a pure solution, its nature may be satisfactorily
81. 2. The only important modifications in the analysis rendered necessary
82. CHAPTER VII.
83. CHAPTER VIII.
84. CHAPTER IX.
85. CHAPTER X.
86. CHAPTER XI.
87. CHAPTER XII.
88. CHAPTER XIII.
89. 3. The arsenite of copper, or _mineral green_. 4. The arsenite of potass
90. 2. _Of the Tests for Arsenious Acid._
91. 7. After the precipitate has thoroughly subsided, the supernatant liquid
92. introduction as a poison into the body. This topic, one of paramount
93. 1. _Arsenic may exist as an adulteration in some reagents._—It must be
94. 2. _Arsenic may be present in some articles of chemical
95. 3. _Arsenic may have existed in antidotes administered during life._—It
96. 4. _Arsenic sometimes exists naturally in the human body._—This
97. 5. _Arsenic may exist in the soil of churchyards._—This proposition too
98. 3. _Arsenite of Copper_.
99. 4. _Arsenite of Potass_.
100. 5. _Arseniate of Potass._
101. 6. _The Sulphurets of Arsenic._
102. 7. _Arseniuretted-Hydrogen._
103. 1. In one order of cases, then, arsenic produces symptoms of irritation
104. 2. The second variety of poisoning with arsenic includes a few cases in
105. 3. The third variety of poisoning with arsenic places in a clear point
106. CHAPTER XIV.
107. 1. _Of Red Precipitate._
108. 2. _Of Cinnabar._
109. 3. _Of Turbith Mineral._
110. 4. _Of Calomel._
111. 5. _Of Corrosive Sublimate._
112. 1. _Hydrosulphuric acid gas_ transmitted in a stream through a solution
113. 1. _Lime-Water_ throws down the binoxide of mercury in the form of a
114. 6. _Of Bicyanide of Mercury._
115. 7. _Of the Nitrates of Mercury._
116. 1. The symptoms in the first variety are very like what occur in the
117. 2. The second variety of poisoning with mercury comprehends the cases,
118. 3. The third variety of poisoning with mercury comprehends all the forms
119. introduction of corrosive sublimate into the stomach. The poison then
120. CHAPTER XV.
121. 1. _Mineral Green._
122. 2. _Natural Verdigris._
123. 3. _Blue Vitriol._
124. 1. _Ammonia_ causes a pale azure precipitate, which is redissolved by an
125. 2. _Sulphuretted hydrogen gas_ causes a dark brownish-black precipitate,
126. 3. _Ferro-cyanate of potass_ causes a fine hair-brown precipitate, the
127. 4. A polished rod or plate of _metallic iron_, held in a solution of
128. 4. _Artificial Verdigris._
129. 1. Should the subject of analysis not be a liquid, render it such by
130. 2. If the copper be extremely minute in quantity, sulphuretted hydrogen
131. CHAPTER XVI.
132. 1. _Caustic potass_ precipitates a white sesquioxide, but only if the
133. 2. _Nitric acid_ throws down a white precipitate, and takes it up again
134. 3. The _Infusion of Galls_ causes a dirty, yellowish-white precipitate;
135. 4. The best liquid reagent is _Hydrosulphuric acid_. In a solution
136. 5. When the solution is put into Marsh’s apparatus for detecting arsenic
137. 1. Subject a small portion of the liquid to a stream of hydrosulphuric
138. 2. If hydrosulphuric acid do not distinctly affect the liquid, or if no
139. 3. If antimony be not indicated in either of these ways in the fluid
140. CHAPTER XVII.
141. CHAPTER XVIII.
142. 1. _Of Litharge and Red Lead._
143. 2. _Of White Lead._
144. 3. _Of Sugar of Lead._
145. 1. _Hydrosulphuric acid_ causes a black precipitate, the sulphuret of
146. 2. _Chromate of potass_, both in the state of proto-chromate and
147. 3. _Hydriodate of potass_ causes also a lively gamboge-yellow
148. 4. _A rod of zinc_ held for some time in the solution displaces the
149. 4. _Goulard’s Extract._
150. introduction of lead into the body; and in the last the whole course of
151. introduction of lead into the body may be presumed to be the real cause.
152. introduction of lead into the system. Dr. Burton thinks it will when the
153. CHAPTER XIX.
154. CHAPTER XX.
155. CHAPTER XXI.
156. CHAPTER XXII.
157. CHAPTER XXIII.
158. CHAPTER XXIV.
159. CHAPTER XXV.
160. CHAPTER XXIV.
161. 1. Apoplexy is sometimes preceded at considerable intervals by warning
162. 2. Apoplexy attacks chiefly the old. It is not, however, confined to the
163. 3. The next criterion is, that apoplexy occurs chiefly among fat people.
164. 4. A fourth criterion is drawn from the relation which the appearance of
165. 5. Another criterion relates to the progress of the symptoms. The
166. 6. Although there is a great resemblance between the symptoms of
167. 7. In the last place, a useful criterion may be derived from the
168. 1. The epileptic fit _is sometimes preceded by certain warnings_, such
169. 2. The symptoms of the epileptic fit _almost always begin violently and
170. 3. As in apoplexy, so in epilepsy the patient _in general cannot be
171. 4. When a person dies in a fit of epilepsy, _the paroxysm generally
172. 5. M. Esquirol, a writer of high authority, says that epilepsy _very
173. CHAPTER XXVII.
174. 1. If there be any solid matter, it is to be cut into small fragments,
175. 2. Add now the solution of acetate of lead as long as it causes
176. 3. The fluid part is to be treated with hydrosulphuric acid gas, to
177. 4. It is useful, however, to separate the meconic acid also; because, as
178. 5. If there be a sufficiency of the original material, Merck’s process
179. 546. There is little doubt that poisoning with opium may cause
180. CHAPTER XXVIII.
181. CHAPTER XXIX.
182. CHAPTER XXX.
183. CHAPTER XXXI.
184. 1. M. Chomel of Paris has related a case of poisoning with the gas
185. 2. The fumes of burning charcoal have been long known to be deleterious.
186. 3. It is probable that in some circumstances a very small quantity of
187. 4. The vapours from burning coal are the most noxious of all kinds of
188. 5. Somewhat analogous to the symptoms now described are the effects of
189. CHAPTER XXXII.
190. CHAPTER XXXIII.
191. CHAPTER XXXIV.
192. CHAPTER XXXV.
193. CHAPTER XXXVI.
194. CHAPTER XXXVII.
195. CHAPTER XXXVIII.
196. CHAPTER XXXIX.
197. CHAPTER XL.
198. CHAPTER XLI.
199. 1. When the dose is small, much excitement and little subsequent
200. 2. When the effect is sufficiently great to receive the designation of
201. 160. In twenty-four hours more the breathing became laborious and
202. 3. The third degree of poisoning is not so often witnessed, because, in
203. CHAPTER XLII.
204. 1. _Poisoning with Arsenic and Alcohol._—A man, after taking twelve
205. 3. _Poisoning with Tartar-Emetic and Charcoal Fumes._—Under the head of
206. 4. _Poisoning with Alcohol and with Laudanum._—Under the head of
207. 5. _Poisoning with Laudanum and Corrosive Sublimate._—Of all the cases
208. 6. _Poisoning with Opium and Belladonna._—A lady, who used a compound
209. 7. In the following cases, the active poisons to which the individuals
210. 2. Apparatus for the distillation of fluids suspected to contain
211. 3. Tube for reducing very small portions of arsenic or mercury. The
212. 4. A small glass funnel for introducing the material into the tube
213. 5. The ordinary apparatus for disengaging sulphuretted-hydrogen. The
214. 6. Instrument for washing down scanty precipitates on filters. It is a
215. 7. Tubes of natural size for collecting small portions of mercury by
216. 8. Pipette, one-fourth the natural size, for removing by suction
217. 9. Apparatus for reducing the sulphurets of some metals by a stream of
218. 36. Quoted by Marx, die Lehre von den Giften, I. ii. 163.
219. 92. Vicarius, Ibidem, Obs. 100. Riselius, Ibidem, Dec. i. An. v. Obs.
220. 1762. See Marx, i. ii. 29.
221. 1. P. 476, changed “exasperated by the use of oil” to “exacerbated by
222. 2. P. 513, changed “I may here add a very opposite instance of
223. 6. Enclosed italics font in _underscores_.
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